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UC Docs Risk Lives to Treat Police Officers in Line of Fire

Published August 2007

In the dark and under fire, with no help and few medical supplies— this is what some University Hospital emergency medicine physicians face in their struggle to save lives.

But it’s not a war zone. It’s what they can expect as volunteers working with the Cincinnati Special Weapons and Tactics (SWAT) team.

The 40 members of the Cincinnati SWAT team are specially trained police officers who undergo rigorous physical and tactical training. They are called out to perform hostage rescue and/or armed intervention, execute high risk search warrants, prevent terrorist attacks, and provide dignitary protection and crowd control.

UC assistant professor Kevin Joseph, MD, is one of six University Hospital emergency medicine physicians who volunteer to serve on the Cincinnati SWAT team and serves as its medical director.

“Police officers risk their lives everyday—this is the least I can do to make sure an officer goes home to his or her family,” he says.

Joseph estimates that less than 5 percent of SWAT units across the country have their own physicians. “It’s unusual for a SWAT team to include physicians, especially those affiliated with an academic institution,” says Joseph.

“Most teams don’t even have a medical director,” says Bill Knight, MD, assistant professor, who has been on the SWAT team for three years. “The hours are bad, it’s dangerous and some people’s spouses don’t want them to risk their lives.”

As part of their emergency medicine residency, physicians must complete training in emergency medical services (EMS), working with Air Care or local rescue squads. Because of UC’s involvement with the Cincinnati SWAT, tactical medicine is another way residents can fulfill their EMS requirements.

Residents can get involved in their intern year. For six months, they accompany a senior member of the team before they are permitted to go out on their own. They must also complete a firearms course and pass the same physical fitness test that police officers take.

Although the Cincinnati SWAT team doesn’t have guidelines for physician involvement, Joseph set standards for physicians who want to join the team.

“If the police have to undergo physical and tactical training, then we should too,” Joseph says. “We wear the same uniform as the officers and carry the same equipment including helmets, ballistic vests and radios. There are two differences—we don’t carry weapons and our armbands say ‘medic’ instead of ‘police.’”

Physicians also carry a backpack with limited medical supplies that weigh about 20 pounds. Although they have minimal medication and equipment, they can establish an airway, control bleeding, start an IV, splint fractures, and handle diabetic emergencies and allergic reactions on scene until an injured person can be transported to the hospital.

Police officers train for two days once a month. They focus on firearms one day and tactics the next. When the physicians’ schedule permits, they are encouraged to attend training.

SWAT teams began developing across the country in the 1970s, according to Doug Ventre, lieutenant and tactical planning/SWAT team commander with the Cincinnati Police Department.

“The doctors volunteer their time to our unit,” says Ventre. “I can’t expect them to take off work, but they are welcome to train with us whenever they can.”

“The Docs Shoot All Our Weapons”“By training with us, the docs are exposed to our tactics and weapons. Although they don't carry firearms, the docs shoot all our weapons, including submachine guns and shotguns, so in the event an officer goes down, the doc can pick up that weapon and protect the officer and themselves.”

Ventre says that by attending training, the physicians can become “comfortable with what we’re doing and how we move.”

Cincinnati SWAT team physicians share a pager number so they all receive a message that the team has been called out. As of June 28 of this year, the SWAT team was activated for 153 incidents, and a physician went with them 61 times.

In 2006, a physician was on scene for 87 SWAT incidents.They ride with SWAT officers to a scene and work with them as they make their entry. Ventre always assigns an officer to protect the physician so “if something happens, the officer is a shield for the unarmed doc.”

Peace of Mind for Families“Having a doctor right there with us makes a huge difference to our guys,” says Ventre. “There’s a comfort level, because they know that if they get hurt, there’s someone who can take care of them. It also gives more peace of mind to our families.”

Joseph and Knight point out that what police officers are thinking about as they enter a scene is very different from what physicians have on their mind.

“Officers are thinking about who’s in there, what kind of felonies they have and if they have weapons,” Knight says. “We’re asking ourselves if there are children in there, and where we should position ourselves so we’re unlikely to get shot but can get to someone quickly if they’re injured.”

Says Joseph, “We not only have to think about treating injured people, but also about the dangers around us. We want to take them out of the hostile environment as soon as possible, but we may not be able to. You could be stuck there treating them with minimal equipment and assistance for a long time.”

Dirty Work“It can also be very dirty and very dark,” Knight adds. “We’ve been in areas where there are needles on the ground, drugs, rats and condoms.”

Not only do the physicians treat the officers at the scene for conditions like lacerations, sprained ankles and broken bones, they also monitor their overall health.

“Officers may tell us about a pain they’ve been having or problems with breathing,” says Knight. “We advise them on treatment and refer them when necessary.”

Knight says that thankfully, they have not had to treat an officer for life-threatening injuries.

“The docs have treated everything from cuts and complications from diabetes to hypertension and sprained ankles. In one incident, a guy put cocaine in his mouth as we were making our entry. When the doc explained what would happen to him if he swallowed it, he spit it out.”

Ventre says the SWAT physicians not only help at the scene, they have also conducted classes for the officers on first aid, how to evaluate hypothermia, and other medical issues.

“Even when they can’t be with us, they’ve taught us what to watch for so we can try to avoid medical emergencies,” says Ventre. “We can’t thank the docs enough for what they do for us.”